Prescription Counseling Assessment
Phar 720 Winter 2006
Ted Williams
Communication
Communication with the patient was generally a strong point of the counseling session. Empathy was expressed with small personal bits of information. All of the patient’s questions were taken seriously and acknowledged as appropriate questions. Non-verbal message expressed interest and respect. The downside of the pharmacist-patient interaction was the use of too many close ended questions. In particular, when asking the patient if they had time to discuss the prescription.
Consultation
The consultation was generally good, with a few notable oversights. The pharmacist failed to ask the patient about other disease states, pregnancy status, and recreational drug use. Although there was a discussion of other medications, this discussion does not preclude other potential health problems. Additionally, the patient’s mentioning of headaches should have prompted some inquiries as to whether Tylenol was effectively managing her headaches. Questions about other medications and supplements were started open ended, and wrapped up closed-ended, keeping the discussion focused. The three primary counseling questions were used effectively and flowed well with the overall counseling session. The demonstration of Albuterol use and monitoring of dosing was reasonably complete, but should have also included the number of doses the patient should expect to get from one container.
Medication Information
The medical information was very strong with one notable exception, the instruction to rinse after use. Although Albuterol can cause oral problems due to some minor oral dryness, rinsing after use will not alleviate these problems. Rinsing only applies to corticosteroid inhalers. Checking on the use of Paxil and other antidepressants was an important part of the counseling session, since some antidepressants do interact with Albuterol. The pharmacist should have cautioned the patient that if she goes back to an antidepressant, to be sure to mention Albuterol, so the physician can make an appropriate recommendation. The pharmacist was correct that Tylenol and Vitamin C do not interact with Albuterol. The agitation sometimes associated with Albuterol was another important side effect. The pharmacist warned the patient of the possible effects and counseled the patient to follow up if it becomes a problem. A further suggestion of taking the medication 30minutes – 1 hour before bed may have been appropriate as well.
Summary and Closure
The pharmacist effectively requested the patient repeat the instructions for use of the medication. The opportunity was used to add a few additional points that were overlooked initially (which is the point of patient reiteration). The pharmacist made a special effort to make sure the patient had the appropriate literature and contact information of the pharmacy and his personal information, which was a nice touch.